back board

[frumpy]

Just wondering who carries back boards with them on typical outings. I can get one for free but don't know if it would be worth having. The biggest issue I have is if I came across someone with a neck/back problem I would just make sure they don't move (until someone qualified arrives to handle the situation). But I guess if SHTF and theres no other choice its good to have and doubles as a stretcher.

thoughts?

 

[Hltoppr]

Didn't see this for awhile. I have a plastic backboard that I will throw on the roofrack for longer trips, or where I'm the designated medic....

Lightweight and easy to strap to the roof, so I figure why not?

-H-

 

[frumpy]

It's still sitting in my office at work as I can't really justify it. I think it's too big of a risk as I don't have the proper trainning. I think if anything a fold up stretcher would be my best bet.

 

[bcrez]

I think you're right... If you're not trained in spine immobilization, attempting to transfer someone to a backboard could do more harm than good. Go get some first-aid training, you wont regret it.

 

[frumpy]

I do have first aid training and thats mainly why I decided against it. Guess I'll have to keep my eyes open for a good deal on a compact stretcher.

 

[yyc_ranger_4x4]

A stretcher will not provide the spinal motion restriction like a backboard will. A stretcher is good for sleeping on, and transporting people who have breaks and fractures, a back board is good for everything.

For a backboard to function properly though, you also need the required straps, headblocks, and padding. I might be tempted to carry one strapped to the underside of my 1/2T canopy on long isolated trips, but other than that I don't think it would be of much use. Stokes baskets can work way better, and they even make carrying a bunch of gear easier with a couple guys.

 

[DarkHelmet]

WHOA There!

There are a few big issues with carrying a backboard on an expedition type trip in addition to just the difficulty of transporting the board itself (not hard if you have a roof rack I guess).

First is having the proper training to use it.

But second, and equally as important in an expedition, back country, wilderness context (all deal with extended transport times) is the issue of back boards actually doing more harm than good. Spend much more than 30-45 minutes on a rigid back board and you'll start developing pressure ulcers (similar to a bed sore). It is extremely uncomfortable for the patient, and once they are on a back board they really shouldn't be released until they are cleared by imaging at a hospital. You also have to deal with an extended transport time in which the patient is going to have to go to the bathroom and again... once on the board they are staying on the board. What if the patient vomits? (it is pretty nauseating riding in a vehicle strapped to a board). There is a whole host of issues you need to be prepared to deal with once the person is immobilized.

You are better off doing two things (if properly trained to do so):

1) Learn the selective spinal immobilization criteria so that you can safely rule out a spinal injury in the back country setting and avoid immobilization.

2) If the patient has a positive spinal injury and immobilization is advised, use a full body vacuum splint (expensive) or use a KED type device in conjunction with a litter/stokes basket and adequate padding for patient comfort.

Otherwise, stabilize in place and wait for professional rescue (if available) or do the best you can with what you have, but in my opinion, if the transport time is more than 30-45 minutes (MAX) the backboard will probably do more harm than good. Unless you are fully equipped and prepared to conduct a self evacuation of the patient, stabilizing in place IS the best option. A spinal injury or suspected spinal injury, in and of itself, is not a life threatening condition. If it is a significant enough injury to immediately cause issues with breathing (such as an upper cervical break) then unfortunately, your patient is most likely screwed anyway without rapid transport to a hospital. If it is a lower spinal injury, or a relatively stable injury, or an unconfirmed spinal injury, then they can be stabilized and supported well until help arrives with all the necessary equipment, manpower, and training to safely conduct the evacuation, even if that takes hours.

I've conducted several rescues of patients that have fallen significant distances, and had a multitude of both internal and external traumatic injuries including later confirmed spinal injuries and they survived for several hours until we arrived and were able to reach them, evacuate them and transport them to a hospital.

Hope that helps.

If you like reading and want to know more about spinal injuries read here about the NEXUS study: http://www.sehsc.org/news/cspine.htm

Here is a great video of a rescue in Canada where the patient had all the MOI, signs and symptoms of a spinal injury (later confirmed by X-Ray) but the conditions and terrain simply didn't allow for immobilization to a board and the patient still had a positive outcome (and it's just a cool video): [ame="http://www.youtube.com/watch?v=I7_4n_4Qhu4"]http://www.youtube.com/watch?v=I7_4n_4Qhu4[/ame]

 

[TheBeatenPath]

i had a good design and sketched out in my head.
it involved taking out my passenger seat and using one of these as a bed. i have a thick sleeping back so i can basically sleep on concrete lol.

but i could sleep in security and if the need arrised i would have a backboard.

but i threw away the paper at school on accident.

 

[Youngunner]

Excellent video. I wonder if they could have used the KED and a stokes in that case?

I tote around a backboard occasionally, usually if I'm out with SAR since I can act as a Paramedic within my county. I think a compact folding military stretcher would be the best bang for buck. Getting the person out of the environment/elements is the first step.

 

[Deleted member 9101]

This is the same problem I ran into in my last deployment... not only do you have to find room to carry it.. but then you need a way to carry it with a person strapped to it.

As as with what others have said, if you are not properly trained in immobilizing a spinal injury.... please don't try it.

 

[24HOURSOFNEVADA]

I think it's a waste of space. I can say that if our SAR team needed to respond to your incident, I have serious doubts we would trust your untested/unknown equipment. Think of the liability the responding team would assume.

This even stands true for simple items such as tow lines for boats when towing vessels in Tahoe and Pyramid.

 

[Pat Caulfield]

I have to ditto DarkHelmet, without the proper training you can cause more damage then good and the current trend in wilderness medicine is away from broad use of back boarding, e.g National Park Service, State of California, Canada, Malayasia, etc. unless there are definitive indicators (MOI/assessment) of a back injury. Most if not all wilderness medical training now stress some form of a focused spinal assessments (NEXUS Protocol).

http://www.wildernessdoc.com/assets/lectures/2010/Spine%20CSEC%20Telluride%202010%20slides.pdf

It is not just the BB, but the padding (very very important), straps (spider harness), head blocks, etc. Also BB are dam near impossible to fabricate in the field (snowboards are too flexible), so it may be a good time to wait for help with the proper gear. In a wilderness context because of the distance to definitive care, saving time in patient packaging is not as critical, e.g. you,re not going to get someone to the ER within the golden hour, even helioing takes more time then most people realize. Don't rush, do it right.

On our SAR team the protocol is try and limit to no more then 60 minutes on the board.

Medical protocols differ between teams (even when from a common source, e.g. Wilderness Medical Society).

My two cents.

 

[HillbillyfromAL]

Frumpy a SKEDCO would be a good asset to move someone that was injured (not spinal). If you let it sit in the hot sun for a while it will even get flat. They are useful for more than just spinal injuries.

 

[frumpy]

I actually got a SKED a few months ago. It's a cool piece of kit (and yes I know it's not a backboard).

 

[zidaro]

Carrying a "backboard" is not so important and long term immobilization on a hard surface can have unintended consequences as mentioned above.
Im not going to get detailed here, but i think the important thing is to be educated enough to recognize when someone in an event has been exposed to and possibly has experienced cervical/spinal trauma.
Now, if your in the middle of nowhere and no-one is going to help you and your hurt friend- are you going to sit on your *** and let them die cuz you are worried abount moving them? You going to stand them up and do jumping jacks down the trail to the highway when they were unconscious a few minutes ago after a cartwheel rollover in their jeep? What if you are now exposed to environment such as wind, snow, heat? You staying there till someone helps you out of your situation?
No. Your going to take care of yourself and safely get your buddies to where they need to be. Call a heli? Great, what if its snowing. blowing, and night? Wait for SAR? Got a full day.
Learning to recognize real injury by training- CPR, 1st aid, EMT (this should be mandatory in high school), Woofer, Medic, etc..., then take the precautions needed for the circumstance.
You could very easily fashion a makeshift board out of anything- roofrack, shovels tied together, dare i say a snowboard or skiis, maxtrax, rolled in a mattress/sleep pads. Perfect, ideal, no. But could save lives. Pad it heavily and roll towels to wrap their head tightly, duck tape or tiedowns to hold them to it securely but dont cut off circulation. One could even securely pack someone into the backseat of another rig in a fashion that would provide a ton of immobilization to the spine, pelvis, chest, etc...
Most trauma care is common sense and protection from further injury.

The idea here is that if you are forced into a position to take care of yourself or others, you must rely on your abilities to think outside the box. that is what being self-sufficient is all about. You cannot prepare for all events, but must be able to overcome the obstacles in front of you.
Train to help people not harm them. Learn to assess and then treat basic injury, recognize serious life-threatening injury. Even if you dont have the skills or tools to treat. Its up to you if you think this person is too seriously injured to move them with the means you have avail., or if its too serious of a situation you are in to stay and wait for help.

Opinions only here